Options for Aneurysm Treatment

Dear Dr. Roach: My question is about my sister, who is 66 years old with aortic disease and who’s had four aneurysms: an ascending aneurysm 4.5 x 4.6 cm, a descending at 4.2 x 4.7cm, and also an abdominal at 2.4 x 3.2 and another just at 2 cm. I missed an in-depth story on the local evening news, but its hook was “a breakthrough on treating aneurysms that dramatically shrinks them.” — K.K.

Answer: An aneurysm is a dilation of a blood vessel at a site of weakness. This can happen in virtually any blood vessel, but they are most concerning in the heart, the brain and the aorta, the main blood vessel that takes the blood from the heart to the body. In your sister, the large aneurysms are in the thoracic aorta, the part of the aorta that is in the chest. The major risk factors for thoracic aneurysms are high blood pressure, high cholesterol and smoking. However, genetic diseases like Marfan’s syndrome and Ehlers-Danlos syndrome should be suspected in younger people with thoracic aortic aneurysms. Infectious and inflammatory diseases like syphilis and giant cell arteritis are uncommon causes.

Medical therapy includes blood-pressure reduction, especially by beta blockers, management of high cholesterol and diabetes if present and tobacco cessation. The decision of when and how to treat aortic aneurysms surgically should be made by an expert.

I don’t know what the “breakthrough” referred to on your news was. However, I suspect it was one of several new devices that are placed inside the blood vessel to let blood flow through while providing strength to the wall. Repair also can be done through an open chest procedure. The decision of when to operate is made by carefully reviewing the size of the aneurysm and how quickly it is growing.

Answer: I am aware that other media doctors have recommended this product. However, I am unable to find enough evidence that it is safe and effective for me to do so, and I recommend against using it for either a sore throat or for sanitizing drinking water.

For sanitizing water, I recommend filtering with a 0.1 micron filter, available at camping supply stores.

Dear Dr. Roach: Should I be concerned with blood tests that show MCV, MCH and mono numbers in the high range? What do high readings indicate? — C.P.

Answer: “MCV” is “mean corpuscular volume,” and “MCH” is “mean corpuscular hemoglobin” — both indicators of the size of red blood cells. The monocyte (“mono”) is a type of white blood cell.

Large red blood cells happen with deficiencies of vitamin B-12 and folic acid. They also come about with many kinds of uncommon and rare blood diseases. Monocyte levels can be high in infections and certain other kinds of blood diseases.

All that being said, the “normal” range from a laboratory is based on a sample of people in the population. By definition, 5 percent of normal, healthy people will have a lab test result that comes out as abnormal. If you get 15 or 20 lab results, there’s a very good chance that at least one will come out abnormal. Lab tests always must be interpreted keeping the whole situation in mind.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.

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